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is this great news or what???


jamie

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Today, My dad got the results from his 2nd PET scan, and while we were all holding our breath, the doctor told us that the radiation and chemo were succesfull, and we got the cancer out of his lymphnodes!!! They are scheduling him to get his tumor removed next month!!! My question is now that his cancer is gone from the lymphnodes, and the tumor has shrunk to 1/4 the original size... will the doctors be changing the stage of his cancer? At dx, he was staged at 3B.

Also, am I being to optimistic in thinking my dad might be beating this thing? It really seems like great news to me, and I hope that Im not setting myself up for dissapointment later... anyone with any expierence please write me back, for now Im gonna go soak in my happiness...

P.S. Excuse the spelling errors,,, Im just to excited!!! :D:D:D

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Well it seems that your dad and my dad are in the same boat!!! My dad was diagnosed in Sept. 03 w/NSCLC IIIB also and he had the same tx of carb/taxol w/concurrent radiation. Well since then he had to go back to chemo because they saw that the lymph nodes were still glowing and couldn't tell if maybe that was just scar tissue or what so just to be sure they sent him back for 3 more chemos of the same stuff.

Well he just got out of the hospital from his surgery on Monday!!! His PET scan also showed no visible cancer outside a pinpoint dot in his lung still. So they went in for a medianstinoscopy to make sure the lymph nodes were just scar tissue (they were) and when they got to the lung it was utterly destroyed they think from radiation damage so he was just supposed to have his lower rt lobe removed and instead they had to take the whole lung. This was last wednesday, the most stressful day of my life because they didn't even know if they would be proceeding w/the surgery they had to wait until they did a few biopsies while they were in there just to be sure and if nothing turned up then they would proceed w/surgery and proceed they did!!! Truth be told they really felt he still had some active cancer in a node or two and also he had a little pleural effusion that they were sure they would find cancer in and much to their surprise.....they DIDN"T!!!! So it was about a 6 hour ordeal by the time they did all the tests etc etc then they finally came out and said we were able to go ahead with the operation and it was like the weight of the world was lifted off all of our shoulders!!! Our family practically took up the entire waiting room (I have 6 siblings and not to mention my mom and his brothers and sisters were all there too) We must have looked like we were in a crazy cult because we were all on our knees holding hands praying over him and the doctors and the hospital and everything :D

We got our prayers answered and he had his surgery; he just found out yesterday that he only has one lung....we felt it best not to tell him until he was in a place mentally to be able to handle it. Praise God, he is doing pretty well considering what he went through (he is a stubborn ole' Italian mule; he is!!!) Since he still had a little cancer in his lung however they may send him back to chemo just for a little insurance that they got everything. So I don't know what will happen from here but I'm just enjoying the victory for now and giving praise to God for his goodness!! Good luck to your dad, I will pray for him; I will!!! I know your stress level; believe me.. Take care and keep us posted.

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Jamie

:D:D:D

What wonderful news that is. You must be the most excited person in the world. I also do not know the answers to your questions regarding restaging. However I would think it is possible, given that people are re-staged when further metastasis are found, why not re-stage when less cancer is present. The important thing to remember is that when you look at statistics presenting data on survival for the different stages, that is referring to stage at diagnosis! BUT!!! I think it is so important to remember that there is not a single cancer out there (that I know of) that kills all people with it. So, certainly it seems your Dad has a fantastic chance of beating this. I wouldn't worry about thinking you shouldn't get so excited now in case there is bad news later. You'll deal with that IF and when it happens. I say go with the good feelings while they are there. Enjoy them and cherish them.

I hope you have lots more good news to follow. How is your Dad going with the one lung?

Thinking of you

Jana

xxx

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Jamie,

I realized that I did not directly answer your questions as to restaging and survival etc. I guess, I don't know right now for sure they are just saying he is "cancer-free". They did not touch upon reoccurrance or anything. He will be having his post-surgery appointments over the next few weeks so if they have anything of note to share then I will pass it along to you. I'm going to just enjoy this time while I have it and I hope you do too!!!

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Great news. Yes this is essentially called "downstaging". Since there is not more cancer in the lymph nodes, he is clinically stage I or II (not sure about the size of the tumor or existance of cancer in the hilar lymph nodes)

That means he can have surgery, which hopefully is curative!

Potential use of FDG-PET scan after induction chemotherapy in surgically staged IIIa-N2 non-small-cell lung cancer: a prospective pilot study. The Leuven Lung Cancer Group

J. F. Vansteenkiste, S. G. Stroobants, P. R. De Leyn, P. J. Dupont and E. K. Verbeken

Department of Pulmonology/Respiratory Oncology, University Hospital Gasthuisberg, Catholic Univesity Leuven, Belgium. johan.vansteenkiste@uz.kuleuven.ac.be

BACKGROUND: Clearance of viable tumour cells in mediastinal lymph nodes (MLN) by induction chemotherapy (IC)--so-called MLN downstaging--is an important aspect of combined-modality treatment of N2-NSCLC. Reassessment of MLN after IC by CT is far from accurate, while re-mediastinoscopy is often technically difficult. Based on our previous results with FDG-PET in the initial staging of N2 disease, we investigated whether PET after IC could be helpful in predicting MLN downstaging and therapeutic outcome. PATIENTS AND METHODS: Patients underwent a first PET before IC. After three cycles of platinum-based IC, a second PET was performed before locoregional therapy, either surgery or radiotherapy. PET results were correlated with pathology of the MLN when available, and with survival. RESULTS: Fifteen surgically staged N2-NSCLC patients were prospectively included. Locoregional therapy after IC consisted of surgery in nine and radiotherapy in six. Correlation with pathology of the nine resection specimens revealed that the accuracy of PET in predicting MLN downstaging was 100% (six true negatives; three true positives), whereas for CT it was only 67% (two false pos; one false neg). Reassessment with PET after IC was correlated with the outcome after the entire combined modality treatment. Survival was significantly better in patients with mediastinal clearance (P = 0.01) or with a greater than 50% decrease in the Standardised Uptake Value (SUV) of the primary tumour (P = 0.03) after IC. CONCLUSIONS: Mediastinal PET after IC accurately assesses pathologic MLN downstaging in N2-NSCLC. The data suggest a possible correlation of early survival with mediastinal clearance and an important decrease of SUV in the primary tumour. Confirmation of these preliminary findings would establish PET as a useful non-invasive tool to select patients for intensive locoregional treatment after IC.

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Induction with chemotherapy with or without radiotherapy leads to objective responses in most patients, many of whom are downstaged. Downstaging predicts survival. A greater percentage of patients treated with induction therapy are able to undergo complete resection.

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Jamie,

Wonderful news about your father. And to answer your question about his chances of beating this....well, all I can tell you is that my "phone buddy" through ALCASE is a wonderful woman who was diagnosed with NSCLC, Stage IIIB, (several positive lymphnodes) and had surgery/radiation/chemo -- she has been cancer free for the past 5 years. She is nothing short of an ispiration!

This can be beaten!

Congratulations again, get out there and celebrate this good news with your father!

Heather

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Thank you guys so much for sharing in the great news... also for all the information. I feel like were starting all over, and we havent met with the doctor for a lengthy apt. yet, so Im sure we'll be finding out more in the weeks to come.

One of the questions we are planning on asking is, staging, and if his prognosis is improved (Im guessing that the answer will be yes :D ), and also I know that we will be finding out how much of the lung they will be removing.

Any concerns I should have about operation? I know all ops are risky, but we think any risk is worth taking since weve come this far.

One thing I forgot to mention, that is pretty important... My dad's father is in the ICU at the hospital now as I type this, dying from Lou Gehrigs disease. I thank God that my Dad got some good news, because my Grandpa isn't expected to live the day. I just wish he could have been awake to hear the good news about my Dad before he dies, because it would have been a great load off his shoulders.

Thanks again for all the support, and if anyone has any stories or information on Op's please let me know... I wish all of you the same luck and happiness Im feeling right now... Keep the posts comin! :D:D

Jamie

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